Document Detail

Comparison of forehead and digit oximetry in surgical/trauma patients at risk for decreased peripheral perfusion.
MedLine Citation:
PMID:  17509425     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Measurement of pulse oximetry (Spo(2)) is often impaired in critically ill patients. Forehead reflectance oximetry, the Max-Fast (Nellcor, Pleasanton, CA), may be less susceptible to poor tissue perfusion and could improve accuracy of oxygen saturation measurement. The objective of this study was to evaluate the use of forehead oximetry measures in critically ill surgical/trauma patients. METHODS: A prospective interventional study of 30 critically ill surgical/trauma patients at risk for decreased peripheral perfusion, as evidenced by need for vasopressor support (24 patients), transfusion of more than 6 unit packed cells in 24 hours (two patients), or an inability to obtain consistent saturation from a digit sensor (four patients), compared forehead and digit-based oximeter Spo(2) readings with co-oximetry (Sao(2)) measurements from arterial blood samples. Sao(2) values were converted to functional oxygen saturation (SO(2)) measurements for the final comparison. Patients were fitted with forehead (Nellcor Max-Fast) and digit (Nellcor Max A; digit 1) sensors connected to Nellcor OxiMax N-595 oximeters and a digit sensor (Nellcor Max A; digit 2) connected to a multiparameter monitor (Philips CMS [Andover, MA]). Three measurements of Sao(2) were obtained from each subject over a 24-hour time period, and simultaneous measurements of Spo(2) were recorded from the three monitors. RESULTS: The three Spo(2) measurements (forehead, digit 1, and digit 2) were compared with SO(2) values using the Bland-Altman method to assess agreement. Forehead measurements demonstrated a mean bias of -1.39, whereas digit 1 was -2.61 and digit 2 was -3.84. Pearson correlations (r) for forehead, digit 1, and digit 2 with SO(2) were .834, .433, and .254, respectively. There were fewer unsuccessful measurements with the forehead oximetry technique. CONCLUSIONS: Forehead sensors improve measurement of oxygen saturation in critically ill surgical/trauma patients at risk for decreased peripheral perfusion.
Lynn Schallom; Carrie Sona; Maryellen McSweeney; John Mazuski
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart & lung : the journal of critical care     Volume:  36     ISSN:  0147-9563     ISO Abbreviation:  Heart Lung     Publication Date:    2007 May-Jun
Date Detail:
Created Date:  2007-05-18     Completed Date:  2007-09-20     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  0330057     Medline TA:  Heart Lung     Country:  United States    
Other Details:
Languages:  eng     Pagination:  188-94     Citation Subset:  AIM; IM    
Barnes-Jewish Hospital, St Louis, Missouri 63110, USA.
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MeSH Terms
Aged, 80 and over
Blood Circulation / physiology
Critical Care / methods*
Fingers / blood supply*
Forehead / blood supply*
Middle Aged
Oximetry / instrumentation,  methods*
Oxygen / analysis
Perioperative Care*
Prospective Studies
Sensitivity and Specificity
Telemetry / instrumentation,  methods*
Time Factors
Wounds and Injuries / physiopathology*
Reg. No./Substance:
Comment In:
Heart Lung. 2008 Jan-Feb;37(1):76; author reply 76-7   [PMID:  18206532 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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